Desert Wellness Psychiatry

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08/09/2026

Genetics matte, but they aren’t the whole story.

While we can’t change our genes, we can influence many of the factors that affect when and how bipolar disorder shows up.

A few important nuances:

• Not everyone who uses cannabis will develop mania.
• A family history of bipolar disorder does NOT mean your children will develop it.
• These are ways to reduce risk, not guarantees.

Research consistently finds that an earlier age at onset of bipolar disorder is associated with more severe illness and greater social and functional challenges over time. That’s one reason why reducing risk factors and recognizing symptoms early matter!

If you’re in mental health or If bipolar disorder runs in your family, what’s one piece of advice you’d want the next generation to hear?

08/06/2026

If you take an antidepressant, you should know this.

Nobody is going to pay closer attention to your health than you.

Most people will never develop serotonin syndrome. But recognizing it early can make all the difference.

One of the most important physical signs is clonus—a rhythmic, involuntary muscle movement that, together with symptoms like sweating, fever, diarrhea, tremor, confusion, or agitation, should prompt urgent medical evaluation.

Here’s the nuance: serotonin syndrome isn’t caused by antidepressants alone. It usually happens when multiple serotonergic medications or substances are combined. Common examples include tramadol, dextromethorphan (found in many cough medicines), triptans for migraines, linezolid, lithium, fentanyl, and M**A.

This isn’t meant to scare you away from treatment. Antidepressants are safe and effective for millions of people. The goal is simply to recognize a rare but important condition if it ever occurs.

Save this so you can find it again—and share it with someone who takes an antidepressant.

This is educational content and isn’t a substitute for medical advice. If you think you or someone else may have serotonin syndrome, seek immediate medical care. Ok, love you 🫶🏻, bye.

08/04/2026

Mixed states are one of the most misunderstood parts of bipolar disorder.

They’re also one of the easiest to miss.

Someone may look “depressed,” but also be:
• Anxious
• agitated
• angry —Irritable
• c attention difficulties— Unable to slow their thoughts

That combo can’t be missed.

A few important pearls:

• Mixed states can occur in both Bipolar I and Bipolar II.
• Many experts consider anxiety, agitation, irritability, and distractibility to be core features—even though they’re not required in the DSM definition.
• Mixed states are associated with greater functional impairment, higher rates of substance use, and a higher risk of suicidal thoughts and behaviors than many other bipolar mood states.

Recognizing a mixed state can completely change treatment.

Psychiatry is full of nuances like this. Follow if you enjoy practical, evidence-based mental health explained simply. 🫶🏻

08/02/2026

☀️ Sunny days don’t always = happy days.

Winter SAD usually means sleeping more, eating more, gaining weight, and feeling slowed down.

Summer SAD often flips the script: trouble sleeping, less appetite, weight loss, restlessness, irritability, and anxiety.

🧠 Want evidence that light matters? Look at Alaska.

Winter-pattern SAD is much more common in northern latitudes like Alaska than southern states like Florida. But during Alaska’s summers, the sun barely sets. Those dramatic seasonal swings in daylight may also help explain why manic and hypomanic episodes in bipolar disorder tend to peak during the spring and summer—especially at higher latitudes.

Here’s the nuance that matters:

SAD isn’t its own diagnosis. It’s a seasonal pattern that can occur with Major Depressive Disorder or Bipolar Disorder—and that distinction changes treatment.

🔆 Winter pattern: bright light therapy has strong evidence.

🕶️ Summer pattern: the goal isn’t simply “more light.” Protecting sleep and managing light exposure may help some people, but treatment depends on the underlying diagnosis. In bipolar disorder, mood stabilizers—not antidepressants alone—are often the foundation of treatment.

⚠️ If summer consistently makes you feel sad, irritable, restless, and with poor sleep, that’s an important detail to tell your healthcare provider. 🫶🏻

The bottom line: 🧠 Season matters. 🌎 Latitude matters. ✅ Diagnosis matters most.

👉👉Share this and Follow for more 🫶🏻

08/01/2026

Bipolar disorder is often oversimplified:

Bipolar 1 = severe
Bipolar 2 = mild

But it’s not that simple.

Bipolar 1 involves full manic episodes that can lead to psychosis, hospitalization, or major life disruption.

Bipolar 2 involves hypomania + major depression. No full mania—but depression is often longer and more persistent.

In fact, bipolar 2 can be just as impairing over time due to recurrent depression.

Treatment differs:
• Bipolar 1 → focus on preventing mania + depression
• Bipolar 2 → focus on preventing depression (+hypomania if troublesome)

Important: antidepressants alone can sometimes worsen bipolar symptoms.

And most people with bipolar disorder can live a productive, fulfilling, and successful life.

The goal is not to pit one vs the other. The goal is the same for both : stability and quality of life.

👇 Questions about bipolar disorder? Drop them below.

07/30/2026

Part 2 of the showdown: Trazodone vs. Ambien.

Here’s where the evidence gets interesting:

💤 Low blood pressure & fainting: Trazodone can cause a drop in blood pressure when you stand up, leading to dizziness or even fainting. Ambien doesn’t work this way.

🚶 Falls: Both medications increase the risk of falls, but trazodone appears to carry the higher risk—likely because it combines sedation with low blood pressure.

⚠️ Abuse potential: This is where the tables turn. Ambien can activate the brain’s reward pathway, which is why it’s a Schedule IV controlled substance. Trazodone doesn’t produce the same “high” and has much lower abuse potential.

The “better” medication depends on your age, medical history, and what risks matter most for you. There isn’t a one-size-fits-all answer.

👇 Which medication has worked better for you: **Trazodone or Ambien? Share in the comments. **

07/28/2026

Some psychopharmacology pearls that didn’t make the video 👇🌿

😴 It may help anxiety—not just sleep.

In one small study, passionflower worked about as well as a prescription anti-anxiety medication (oxazepam).

People taking passionflower had fewer problems with work performance.

often its combined with valerian, lemon balm, or hops. Sometimes all of the above.

📣 Come learn more about complimentary and integrative medicine | October 8 – 11, 2026 | Town and Country Resort, San Diego and online.

Use link in my bio and codes

JLUA26IP – $100 off any in-person ticket
JLUA26VT – $50 off any virtual ticket

Don’t forget kids get in free to zoo, legoland, etc in Oct.

See you there!

07/26/2026

The science is more nuanced than a 60-second reel. 👇
The original University of Washington research found that abusive men tended to fall into two broad groups:
🐍 “Cobras” — their heart rate decreased during conflict. They were more likely to have antisocial traits, use intimidation and coercive control, and be violent outside the relationship.
🐕 “Pit Bulls” — their heart rate increased during conflict. They tended to be more emotionally reactive and dependent on the relationship.
Two years later, about 27.5% of the “Pit Bull” couples had divorced.
The “Cobra” couples?
0%.
That doesn’t mean those relationships were healthier. In abusive relationships, fear, coercive control, financial dependence, and trauma bonding can make leaving incredibly difficult.
⚠️ Important caveat: Later studies struggled to reproduce this exact “Cobra vs. Pit Bull” classification, so it shouldn’t be viewed as settled science.
What has held up much better is the broader finding that lower resting heart rate (which is different from heart rate during conflict) is associated with higher rates of aggressive and antisocial behavior across many studies.
Heart rate isn’t a diagnostic test. Behavior always matters more than physiology. Look at their actions. Understand your values. Catch the red flags early 🚩
💭 Why do you think none of the “Cobra” couples divorced?

07/25/2026

Most people assume the most prescribed sleep medication has the strongest evidence.

It doesn’t.

🥊 Ambien vs. Trazodone

📚 Ambien (zolpidem) is FDA-approved for insomnia and has much stronger evidence. The largest analysis of insomnia medications (170 trials, ~48,000 patients) supported zolpidem with moderate-to-high certainty.

💊 Trazodone isn’t FDA-approved for insomnia. Both the American Academy of Sleep Medicine (AASM) and the VA/DoD guidelines recommend against routinely using it for chronic insomnia—but for slightly different reasons. The AASM cites insufficient high-quality evidence. The VA/DoD found no meaningful benefit over placebo, although the trazodone studies were few, short (about 1.7 weeks), and included comparisons like 50 mg trazodone vs. 10 mg Ambien.

😴 Trazodone is more likely to cause next-day grogginess because it stays in your system much longer.

🚗 Ambien’s tradeoff? It carries an FDA boxed warning for rare but serious complex sleep behaviors like sleepwalking, sleep-driving, and eating while asleep.

Six more rounds are coming—including withdrawal, dependence, sexual side effects, dementia use, and the category that completely surprised me. Follow so you don’t miss the rest of the matchup.

Which team are you on: Trazodone or Ambien?

Address

35800 Bob Hope Drive Suite 210
Rancho Mirage, CA
92270

Telephone

+17605374223

Website

http://www.desertwellnesspsychiatry.com/, https://linktr.ee/dr.johnnygonzalez

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